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- Title
The Role of Emergency Drainage of the Kidney in Infected Hydronephrosis.
- Authors
Martha, Orsolya; Szekeres, N. A.; Porav, D.; Vida, A. O.; Csillag, I.; Frunda, E. A.; Brad, A. B.
- Abstract
Introduction and Objectives. In urological practice one of the most important emergencies is considered the infected hydronephrosis, with great potential to evolve in urosepsis. These situations require an urgent drainage of the upper urinary tract with double J catheter or percutaneous nephrostomy. The aim of the study was to evaluate the efficacy of early renal drainage in the management of infected hydronephrosis and also to identify microbial pathogens involved in urinary tract infections. Materials and Methods. This retrospective cohort study analyses clinical data of 101 patients (100%) with upper urinary tract drainage performed for infected hydronephrosis, at the Clinic of Urology Targu Mureș, in a period of 28 month. Results. The mean age of the patients was 57 years, male-female ratio: 64 female, 37 males. The aetiology of the hydronephrosis in 74 cases (73.26%) was uretherolythiasis, in 8 cases (7.92%) musculo-invasive bladder cancer, in 3 cases (2.97%) pyelouretheral junction syndrome, in 4 cases (3.97%) gynaecological tumors (uterine, cervical cancer), in 2 cases (1.98%) retroperitoneal fibrosis, in 2 cases (1.98%) ureteral stenosis, in 2 cases (1.98%) ureteral urotelial cancer and other causes in 4 cases (3.96%). In the majority of the cases (72.27%) the renal drainage was performed by JJC insertion, in 23.76% of the patients a percutaneous nephrostomy while in 3.96% of cases a nephrectomy was performed. Additional antibiotic therapy was conducted based on the microbiological findings: 37.2% E coli, 18.6% Enterococcus spp, 13.95% Klebsiella Pneumoniae, 9.30% Proteus mirabilis and in 20.95% of the cases for other pathogens. Conclusions. Infected hydronephrosis, because of its rapid onset and septic evolution, should be considered a urological emergency, requiring a renal drainage as soon as possible. The two ways of drainage: double J catheterization and percutaneous nephrostomy combined with an early, wild spectrum antibiotherapy are the main goals of the proper management of infected hydronephrosis.
- Subjects
HYDRONEPHROSIS; RETROPERITONEAL fibrosis; URINARY tract infections; DRAINAGE; URINARY catheterization; URINARY organs; KLEBSIELLA pneumoniae
- Publication
Romanian Journal of Urology, 2018, Vol 17, Issue 3, p5
- ISSN
1223-0650
- Publication type
Article